Postgraduate Diploma in Learning and Teaching

Oxford Learning Institute
University of Oxford

in Higher Education (PGDipLATHE)

Application Form 2015 - 2016

The following factors will be taken into account in selecting participants for the PG DipLATHE:

The teaching or learning support that you undertake. You must be working for the University of Oxford or one of its Colleges, and be undertaking sufficient teaching (or learning support) to be able to benefit from the course. You should be teaching for a minimum of three hours per week during Michaelmas and Hilary terms.

The level of influence you have on others’ teaching. Priority is given to those who have responsibility for the organisation of teaching or for the quality of learning, teaching or the learning environment. However, places are allocated to staff who do not currently have this level of responsibility but who would like to prepare, through the course, to take on leadership responsibilities for learning and teaching in the future.

Division, Faculty or Departmentalendorsement. Priority is given to members of staff who have been endorsed by their division, faculty or department.

The primary aim of the course is to enhance teaching, course design and the learning environment at Oxford. Therefore, permanent members of University and College academic staff are most likely to fit the selection criteria as outlined above. However, places have been allocated to staff in other categories: for example, research staff working on fixed term contracts and those who teach on a part-time or hourly-paid basis. For staff on fixed-term externally funded posts: as the course is lengthy and intensive, it is a minimum requirement of entry that you should have sufficient time remaining on your employment contract to complete the course. Where appropriate, you should also obtain the formal agreement of your supervisor and (in some cases)the funding body.

Please bear these selection criteria in mind when completing the form. A requirement of the course is to attend the core seminars. Please check that you are able to attend all the following dates. You should also be prepared to commit, averaged over the year, approximately a half day per week to individual reading, writing and completion of small group assignments. Finally, the course requires a high level of English language proficiency in order to participate fully in group discussions, read dense reading materials in a field outside your own disciplinary specialty and completion of written assignments. Please ensure you complete the form fully and submit it before Monday 30March 2015.Interviews, if necessary,will be conducted with applicants in April or May. All applicants will be notified as to whether they have a place by Friday, 6 June 2014 (6th Week, TT).

September / Seminar 1 / Monday, 21 September 2015 / 9:30 – 4:30 pm
Seminar 2 / Tuesday, 22 September 2015 / 9:30 – 4:30 pm
Seminar 3 / Friday, 25 September 2015 / 9:30 – 4:30 pm
January / Seminar 4 / Thursday, 14 January 2016 / 9:30 – 4:30 pm
Seminar 5 / Friday, 15 January 2016 / 9:30 – 4:30 pm
March / Seminar 6 / Thursday, 17 March 2016 / 9:30 – 4:30 pm
Seminar 7 / Friday, 18 March 2016 / 9:30 – 4:30 pm
June / Seminar 8 / Wednesday, 15 June 2016 / 9:30 – 4:30 pm
Portfolio Submission / Monday 10 October 2016 / 4.00pm

Oxford Learning Institute
University of Oxford

OSS Ref / LAST NAME:
______ / FIRST NAME:
______ / For office use only
OSS Ref
Postgraduate Diploma in Learning and Teaching in Higher Education (PGDipLATHE) - Application Form 2015 -2016
Please complete all sections
Section A: Participant status and teaching responsibilities
University Card Number:
(if applicable) / ______
Discipline:
Department or Faculty:
University Division: (MPLS, MedSci, Social Sciences or Humanities)
Years of Teaching Experience:
Job Title (please select): /  UL/CUF
 Departmental Lecturer
 Associate Professor
 College lecturer
 Career Development Fellow
 Other (please specify)
Nature of Oxford Post (please tick as many as appropriate): /  Full Time
 Part time
 Permanent
 Hourly paid
 Fixed term (renewable)
 Fixed term (non-renewable)
If your post is fixed term, when does it expire?
College, Society or Permanent PrivateHall Association:
Average number of hours of contact time per week with learners:
Type of students (please tick as many as appropriate): /  Undergraduates
 Postgraduates
 Clinical
 Continuing Education
 Visiting students/summer school
 Online/distance
 Others (please specify): ______
______
Duties include (please tick as many as appropriate): /  Lecturing
 Tutorial Teaching
 Small Group Teaching
 Language Instruction
 Demonstrating
 C & IT
 Clinical Teaching
 Curriculum Development
 Leading teaching, learning, assessment or course review activities in a College, department or programme (e.g. Senior Tutor, director of study, chair of a course review team) Please specify:______
______
 Others (please specify): ______
______
Section B: Your Personal Details
FAMILY NAME / TITLE (Mr, Mrs, Ms, Miss, Mx[1]Dr, Professor, Rev, etc.)
GIVEN NAME / SEX: FEMALE  MALE 
MIDDLE NAME(S) / DATE OF BIRTH:day _ _ / month _ _ / year _ _ _ _
PREFERRED GIVEN NAME / PREVIOUS GIVEN NAME (if applicable)
PREVIOUS FAMILY NAME (if applicable)
Section C: Contact Information
HOME ADDRESS / CORRESPONDENCE ADDRESS (if different)
CITY: / CITY:
POSTAL/ZIP CODE: / POSTAL/ZIP CODE:
COUNTRY: / COUNTRY:
EFFECTIVE DATES:From:day _ _ /month _ _ /year _ _ _ _
To: day _ _ /month _ _ /year _ _ _ _
TELEPHONE (if you give more than one, please indicate which is the primary contact number)
TYPE (mobile/cell phone, daytime, evening, etc) / COUNTRY CODE
(if outside UK) / AREA CODE / NUMBER
PRIMARY EMAIL ADDRESS (this should not be an institutional email address that will expire)
Section D: Nationality & Citizenship
COUNTRY OF BIRTH:
COUNTRY OF NATIONALITY/CITIZENSHIP. Please include all countries that you have nationality of and give an effective date if you have not been a national of that country from birth. Please do not give an end date unless your nationality of that country has ended. If you are NOT a national of an EEA country (Including UK, Channel islands, Isle of Man) or Switzerland, please give the number, nationality and expiry date of the passport that you currently use to enter the UK.
COUNTRY / FROM (dd/mm/yyyy) / TO (dd/mm/yyyy) / PASSPORT NUMBER
AND EXPIRY DATE
COUNTRY OF RESIDENCE. Please give details for the past 6 years. This should be the country in which you are normally resident not the country in which you are studying. In the case of EU nationals who are currently studying in the UK, please include details of your UK residence here. Please do not give an end date unless you no longer reside in that country.
COUNTRY / FROM (dd/mm/yyyy) / TO (dd/mm/yyyy)
If you are not a UK or EU Citizen but you are currently living in the UK do you have indefinite leave to remain? Yes
Section E: Details of Current & Previous Education
University/Institution attended / Start year / Year of completion / Qualification obtained or studying for (e.g. BA,MSc) / Main subject
(e.g. Chemistry, English) / Result (grade, classification, GPA etc.)
Section F: Further questions

Please list the courses you will be teaching, or expect to teach, during the next academic year (2014-15)

Please describe any positions of responsibility you hold, particularly those relating to teaching, examining, curriculum development, quality assurance or enhancement:

Please describe how you would expect to find time for the PG DipLATHE. This should be discussed with your employer before applying to ensure that you have a clear understanding of the level of support you can expect to receive in your workplace. Divisions are in receipt of funds to be spent on improving the quality of teaching and learning, and so it may be possible for your Division to provide you with a degree of “buy-out”.

Please give your reasons for wanting to undertake the PG DipLATHE course.

Career Development – e.g. preparation for leadership role in learning and teaching
Qualification
Professional recognition (HEA) / Improving:
My teaching
Student learning
Mentoring of early career academics on teaching
Curriculum/course/programme design
Increasing:
Satisfaction in teaching
Enjoyment of teaching
Understanding of scholarly principles underpinning learning and teaching / Other (please explain):

Please describe particular goals, projects or challenges in learning and teaching that you would like to address through the course.

How were you attracted to apply to this course? Please select one or more option(s) below.

I received an email circular with information on the course
My department encouraged (or nominated) me to apply for it
I found out about it through the staff gateway section of the University website
I read the course leaflet
A friend/colleague recommended me the course (who:______)
I attended other Institute‘s activities and found out about this course
I searched the Institute website and found this course that interested me
Other, please specify:

Has your department/college endorsed you for the course? Please list the name, title and contact information for the person who is endorsing your application.

Please indicate any additional comments.

Statement and Signature
I CONFIRM that the information provided is, to the best of my knowledge, complete and accurate. Participants who wish to obtain a University card to enable them to obtain access to the Bodleian library virtual resources are also required to acknowledge that they have read and agreed to the declaration below.
Bodleian Declaration: I hereby undertake not to remove from the Library, or to mark, deface, or injure in any way, any volume, document, or other object belonging to it or in its custody; not to bring into the Library or kindle therein any fire or flame, and not to smoke in the Library; and I promise to obey all rules of the Library.
Signed: ______
Date: ______
Please return this form by email to the PGDipLATHE Course Administrator at the following email address by Monday 30 March 2015.
Statistical Supplement: Disability Full Name of Applicant: ______
The University is committed to making reasonable adjustments to enable students with disabilities including dyslexia, dyspraxia, students on the Autistic Spectrum or with long-term health conditions to participate fully in student life. In order to provide study support, relevant departments and colleges of the University may need to share information about your needs. Information will be shared on a need-to-know basis with relevant people such as the lecturers and tutors who will teach you, and any library and support staff. The information provided is also used to monitor rates of participation in Higher Education by particular groups of people, which is a statutory requirement; it does not form part of any assessment of your application. If you wish to discuss this section of the application form, or anything to do with University provision for such needs, please contact the Disability Advisory Service or refer to their website .
Please enter the code most appropriate to you:
00 I am not disabled
01I have a disability and am in receipt of a UK Student Disability Allowance
02I have a disability and am NOT in receipt of a UK Student Disability Allowance
If you have indicated that you have a disability, please enter the code in the box from the list of statements below which is most appropriate to you:
51You have a specific learning difficulty such as dyslexia, dyspraxia or AD(H)D
58You are blind or partially sighted
57You are deaf or have a hearing impairment
56You are a wheelchair user or have mobility difficulties
55You have mental health difficulties
08You have two or more impairments or disabling medical conditions
53You have a social/communication impairment such as Asperger’s
54You have a long standing illness or health condition such as cancer
96You have a disability, impairment or medical condition not listed above
Statistical Supplement: Ethnicity Full Name of Applicant: ______
Please provide the number most appropriate to you:______
10 White
15Gipsy/Traveller
21 Black or Black British – Caribbean
22 Black or Black British – African
29 Other Black background
31 Asian or Asian British – Indian
32 Asian or Asian British – Pakistani
33 Asian or Asian British – Bangladeshi
34 Chinese or other ethnic background – Chinese / 39 Other Asian background
41 Mixed – White and Black Caribbean
42 Mixed – White and Black African
43 Mixed – White and Asian
49Other Mixed background
50 Arab
80 Other ethnic background
90 Not known
98You do not wish to provide this information

[1] Mx (Mixter) is a gender-neutral title for those who do not wish to use a gender-specific title or who identify as transgender